Urinary tract infection at the service of urology: Epidemiological and
bacteriological aspects at the Marrakech University Hospital

Introduction: Urinary tract infection is one of the most frequent infections in hospital practice. It covers a
range of clinical situations, symptomatology and gravity ranging from simple asymptomatic bacteriuria to
complicated acute pyelonephritis. In urology, it is a constant concern because of their frequency, their
morbidity, the lengthening of their stay and the resistance of the germs to antibiotics. OBJECTIVE: To
assess the incidence of urinary tract infection in hospitalized patients in urology, to determine the
bacteriological characteristics and risk factors of urinary tract infection in urology. MATERIAL AND
METHODS: Prospective study carried out over a period of 6 months (July 2016 - December 2016) at the
microbiology laboratory of the CHU Mohammed VI in Marrakech, including all urinary infections
documented by a positive ECBU from the urology department of CHU Med VI. Identification and
antibiogram were performed using the Phoenix 100 (Becton Dickinson) and by manual methods.
Interpretation of antibiotic sensitivity was made according to the recommendations of the CA-SFM. The age
and clinical and bacteriological data of the patients included were recorded on a farm record. RESULTS:
During the study period, 121 records meeting the urinary tract infection criteria were selected. The
prevalence of urinary tract infection in urology was 25.6%. The average age of patients was 52.2 years with
a sex ratio of 0.9. 17% of patients were smoking and 8% were diabetic. The most common reason for
hospitalization was bladder tumors (43%) followed by stenosis of the urethra (14%). Urinary signs were
dominated by voiding burns (78.5%), followed by pollakiuria (61%). 51% of patients received endoscopic
surgery and 19% were surgical. 60% of the patients were surveyed. 50% of patients received probabilistic
antibiotic therapy covering the invasive procedure. 62% of urinary infections were nosocomial. The
appearance of urine was cloudy in 58.6% of cases, with significant leukocyturia in 90% of cases, and
significant hematuria in 92%. 90% of the strains isolated were Gram-negative bacilli with a predominance
of Escherichia coli (41%) and Klebsiella pneumoniae (30%). In enterobacteriaceae, the resistance to
amoxicillin-clavulanic acid was 73%, and that to C3G was 43.75%. For non-fermentative Gram-negative
bacilli, the resistance to Ceftazidime was 43%, and to the Imipenem of 36%. Fluoroquinolone resistance in
uropathogenic isolates was 58.8%. CONCLUSION: The results of this study highlight the problem of
urinary infections in hospitals, particularly in the urology department, where the use of invasive urological
maneuvers is frequent. Timely microbiological surveillance and assessment of antibiotic resistance is a
defense against the emergence of new bacterial strains increasingly resistant to broad-spectrum
antimicrobials, making therapeutic options increasingly limited.
Keywords : Urinary infection, Enterobacteriaceae, resistance.